Tag Archives: mental health

Anxiety – It’s not a ‘real’ disease until it is

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“I feel awful, doc”, one man said to me today. “I’m never going to call a cold ‘the flu’ again”, he said as he shivered away under three jumpers, aching and mildly delirious.

It’s the middle of winter here in Australia, and Influenza A is cutting a swathe through the community. Everyone who walks in with a stuffy nose thinks they have ‘the flu’, that is, until they actually get Influenza and they realise just how atrocious having the real flu is.

It’s the same with mental health and illness. So many people think think that anxiety or depression aren’t real diseases. They think that everyone gets a bit sad at times, or gets a bit stressed, so depression and anxiety aren’t real diseases, they’re just normal emotions, or what weak people experience because they don’t have the inner strength to cope.

Such stigma isn’t helped when people who like to think they’re experts in mental health write blogs which declare that “anxiety is a signal that we need to listen to, not an illness we need to manage. It is a reaction to life’s challenges, not a biological disease to be treated.”

Yes, that’s right people, pretend experts are quick to tell you that the debilitating condition you’re experiencing isn’t a real disease.

Saying “Anxiety isn’t a real disease, it’s just a warning sign, a normal part of life” is a bit like saying, “You don’t really have Influenza, you just have a cold. Harden up princess … you don’t need to be ventilated in ICU, it’s just a virus. I took some Vitamin C and I was better in just a couple of days. What’s wrong with you?”

Part of the problem is because of how we use the word “anxiety”, which can mean different things to different people. To a lot of people, being anxious is the same as being a little frightened. To others, it’s being really scared, but with good reason (like if you were confronted by a very venomous snake).

Medically speaking, anxiety isn’t just being frightened or stressed. After all, it’s normal to be frightened or stressed. A little bit of fear is protective. There are dangers all around us, and our brain is our “don’t get killed” organ. If we had no fear at all, we’d end up becoming road kill. A little bit of fear, in the right amount, for the right reason and in the right place and time, is actually very protective.

But to label all anxiety as normal, or to claim that anxiety is not a mental illness is obnoxious and ignorant.

That’s because anxiety at the wrong time and in the wrong amount can disrupt our day-to-day tasks and make it hard to live a rich and fulfilling life. At the extreme, anxiety disorders are as debilitating as any major illness.

There are six main disorders that come under the “anxiety disorders” umbrella, reflecting either an abnormal focus of anxiety or an abnormal intensity:
1. Panic Disorder (abnormally intense anxiety episodes)
2. Social Anxiety Disorder (abnormal anxiety of social interactions)
3. Post-traumatic Stress Disorder (abnormally intense episodes of anxiety following trauma)
4. Obsessive-Compulsive Disorder (abnormally intense and abnormally focussed anxiety resulting in compulsive behaviours)
5. Specific phobias (abnormally focussed anxiety on one particular trigger), and
6. Generalised Anxiety Disorder (abnormal anxiety of everything)

The common underlying theme of anxiety is uncertainty. Clinical psychologists Dan Grupe and Jack Nitschke from the University of Wisconsin wrote in Nature Reviews Neuroscience that “Anxiety is a future-orientated emotion, and anticipating or ‘pre-viewing’ the future induces anxiety largely because the future is intrinsically uncertain.” [1]

The fear of uncertainty that defines anxiety comes from genetic changes that affect the structure and function of the brain, primarily in the regions of the amygdala and the pre-frontal cortex. As a result of these changes, the brain processes information incorrectly.

For example:
> the brain thinks that threats are more likely and will be worse than they are,
> the brain spends more time looking for possible threats,
> the brain fails to learn what conditions are safe, which is aggravated by avoidance, and
> the brain assumes that unavoidable uncertainty is more likely to be bad than good.

It’s important to understand at this point that anxiety disorders aren’t the result of poor personal choices. They’re the result of a genetic predisposition to increased vulnerability to early life stress, and to chronic stress [2]. The other way of looking at it is that people who don’t suffer from anxiety disorders have a fully functional capacity for resilience [3,4].

The main point of this post is simply this – pretend experts are everywhere, and they are usually various combinations of ignorant, stupid or lazy. They might try and tell you that your debilitating anxiety isn’t really a mental illness, but they’re usually the ones who have never experienced just how atrocious a true anxiety disorder is. Don’t listen to them, no matter how many equally ignorant followers they have on social media. Just like Influenza can make you really sick but there is treatment, so it is with an anxiety disorder – the anxiety disorder may be much harder to get through, but with the right treatment and support, you can get through it.

~~~

If you are struggling with anxiety or depression, help … real help … is available. See your general practitioner or psychologist, or if you’re in crisis and you need to talk to someone urgently:

In Australia
> you can call either Lifeline on 13 11 14, or
> BeyondBlue provides a number of different support options
> the BeyondBlue Support Service provides advice and support via
>> telephone 24/7 (call 1300 22 4636)
>> daily web chat (between 3pm–12am) and
>> email (with a response provided within 24 hours) via their website https://www.beyondblue.org.au/about-us/contact-us.
In the US
> call the National Suicide Prevention Lifeline by calling 1-800-273-TALK (8255).
In New Zealand
> call Lifeline Aotearoa 24/7 Helpline on 0800 543 354
In the UK
> Samaritans offer a 24 hour help line, on 116 123
For other countries, Your Life Counts maintains a list of crisis services across a number of countries: http://www.yourlifecounts.org/need-help/crisis-lines

References
1. Grupe DW, Nitschke JB. Uncertainty and anticipation in anxiety: an integrated neurobiological and psychological perspective. Nature reviews Neuroscience 2013 Jul;14(7):488-501.
2. Duman EA, Canli T. Influence of life stress, 5-HTTLPR genotype, and SLC6A4 methylation on gene expression and stress response in healthy Caucasian males. Biol Mood Anxiety Disord 2015;5:2.
3. Wu G, Feder A, Cohen H, et al. Understanding resilience. Frontiers in behavioral neuroscience 2013;7:10.
4. Russo SJ, Murrough JW, Han M-H, Charney DS, Nestler EJ. Neurobiology of resilience. Nature neuroscience 2012 November;15(11):1475-84.

Dr Caroline Leaf and Zombie Chemical Imbalance Myth

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Sometimes if you tell a story often enough, people forget that it’s just a story and it takes on a life of its own. It’s like a zombie … the story isn’t real but it continues to wander around eating people’s brains and it’s very hard to kill off.

Dr Caroline Leaf is a communication pathologist and self-titled cognitive neuroscientist. She also believes that reading a few blogs from fringe psychologists entitles her to call herself a mental health expert. She is the Christian church’s pin-up girl for the Dunning-Kruger effect.

Dr Leaf recently posted a blog on “The Chemical Imbalance Myth”. It’s a zombie. She’s posted on this before (on the 26th of October 2015 to be precise) but her blog post in 2015 was so inaccurate that she later took it down, only for it to resurface later on her website (in the section dubiously titled “Scientific FAQ”).

And like every good zombie, it’s resurfaced again. Dr Leaf hasn’t changed any of the inaccuracies that forced her to take down the original post, but instead added a couple of extra bits in, mixed it up a little and then just served it up, like a reheated bowl of rancid Christmas scraps.

I won’t go through each and every point like I did with her previous iteration of this blog, although if you want to review my more in-depth analysis of this subject, then please feel free to read my previous blog post: https://cedwardpitt.com/2015/10/26/dr-caroline-leaf-and-the-myth-of-chemical-imbalances-myth/. But I thought it was worth highlighting a couple of key things from this year’s fetid reincarnation which are so flawed that not even a B-grade science fiction writer would seriously entertain them.

THE MIND AND THE BRAIN

Dr Leaf says:

“In other words, mental ill-health is a thought disorder based in the mind, which changes the brain physiologically and is a response to the complex and multifaceted challenges of life.” This is based on her underlying assumption that the brain doesn’t control the mind, but instead the mind controls the brain.

However, she also says that “Psychotropic drugs can directly affect our health, with side effects such as an increased risk of suicide, loss of sexual ability, potential brain shrinkage, agitation, insomnia, weight gain and obesity-related diseases like diabetes, lethargy, mental fog, emotional apathy, homicide”.

This statement is really ignorant and prejudiced; psychiatric drugs don’t make people into murderers for a start.

But the most striking flaw of all is that Dr Leaf is contradicting herself. She confidently asserts that psychotropic medications and their terrible chemical imbalances have ghastly side effects on emotional and cognitive functions such as “mental fog” and “emotional apathy”. But how can that be? After all, if the brain does not control the mind as she says, then the medications affecting the brain would not have any effect on the mind.

Dr Leaf can’t have it both ways – either her entire ministry is built on a false premise (the brain really controls the mind after all) or her dire assertions about psychiatric medications are unfounded (chemical imbalances in the brain can’t cause effects on the mind).

One way or the other, Dr Leaf has a serious problem in her reasoning.

Real science has clearly demonstrated that the mind is a product of the brain. Things that alter the structure of the brain (trauma, tumours) or the function of the brain (medications like ropinirole, every day drugs like caffeine, or illicit drugs like LSD) can all cause changes in how the mind functions with resulting changes in behaviour.

If Dr Leaf isn’t able to get the basics of science right and make even the most basic cogent argument then how can she be trusted to speak to more complicated issues surrounding mental health and illness.

DR LEAF’S RESEARCH

Dr Leaf has never been one to undersell her scientific work. Accordingly, in her blog post she says:

Following a similar research path, I have also demonstrated, using my research on the power of mind-action in changing the brain, that mental disorders are primarily based in the mind …

I have researched the effectiveness of mind action techniques (which are thought-based) in overcoming the negative effects of neurological issues such as TBI, dementias, movement disorders, autism, aphasia, and learning disabilities, emotional trauma as well as various cognitive, emotional and mental health issues …

My Geodesic Learning Theory has been shown not only to be effective in mental health care, but also treating physical damage to the brain that occurs in Traumatic Brain Injury (TBI), learning disabilities and to improve learning techniques in both schools and the corporate world …

my research and experience indicated that many of these conditions were influenced by, or originated in, a disorder of the mind that was either caused by a trauma or negative thinking patterns. In other words, mental ill-health is a thought disorder based in the mind, which changes the brain physiologically and is a response to the complex and multifaceted challenges of life.

And yet the reality is that Dr Leaf only did one PhD in South Africa, and has not done any other university based research since. Her PhD did not look at “the power of mind-action in changing the brain”. In fact, her research didn’t focus on mental health or illness at all, and it certainly didn’t focus on dementias, movement disorders, autism, aphasia, and learning disabilities, emotional trauma, cognitive, emotional or mental health issues.

Her PhD was the evaluation of her Geodesic Learning Theory on a group of very normal students in a South African School. None of them had dementia. None of the other conditions were mentioned either. The overall results were likely due to chance, and in some cases, her intervention made the students grades worsen. The only other research that Dr Leaf performed was a similar intervention in come schools in Dallas, but the results were much the same as her PhD and given the unflattering results, this study was never published in a peer-reviewed journal.

Dr Leaf should know what she studied for her own research, and yet her description in her current blog post is so strikingly different from what is on the public record. So again, this begs the question – how can someone who is so wrong about her own research be trusted with any level of authority in any other subject?

PREJUDICE AGAINST MENTAL ILLNESS

For someone who claims to be an expert on mental health, Dr Leaf is extremely callous and dismissive of those people who suffer from mental illnesses. She repeatedly uses quotation marks to refer to mental illnesses, like ‘“diseases” like depression’ as if to suggest that they aren’t illnesses at all. Can you imagine if this same level of disrespect was applied to someone with a physical disability? That people in wheelchairs have the “disability” of paraplegia, for example. It’s extremely disrespectful and intolerant whether it is speaking about a physical disability or a mental illness.

The other thing which is highly inappropriate is her scare-mongering about psychiatric treatments. Psychiatric patients are not imprisoned, drugged, locked in solitary confinement and compelled to “live their days marinating in their own excrement.” I doubt whether Dr Leaf has ever set foot in a psychiatric facility. She is simply regurgitating the information fed to her by alarmist groups such as Mad In America, a group of psychologically trained rogue extremists – the Taliban of the world of psychiatry. It’s propaganda in it’s purest form, but Dr Leaf takes it at face value and repeats it no matter how inaccurate it actually is.

Dr Leaf’s criticism of modern psychiatry is breathtaking in it’s ignorance, especially in the face of published science, but what makes it more concerning is that it is internally inconsistent her own teaching, and this isn’t the first time that she’s contradicted herself.

Dr Leaf should take down this ignorant, inaccurate and intolerant post. This particular zombie myth needs to be buried once and for all.

Stop mislabelling labels.

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The last time I looked through the supermarket, I bought some baked beans. How did I know the can I took off the shelf was full of baked beans and not freshly harvested sheep’s innards? Because the label on the can said so.

Labels aren’t perfect of course. Every now and then, a can of something has the wrong label applied in the factory. Usually it’s nothing too sinister – no accidental swaps of some goat entrails instead of your tinned salmon. Instead, it’s usually something similar – tuna gets labelled as salmon and vice versa, and the worst that happens is that the tuna mornay you’ve just made had an unexpected flavour.  Even these sorts of mild mix ups are rare. Overall, we trust that the labels are guides and the information they provide us helps us make an informed decision about what do to with that particular can and its contents.

It would be pretty silly for some random person to preach out the front of the supermarket, ranting about how all labels for a particular thing are all wrong.

“Uh, just because the occasional can of tuna was accidentally filled with cat food doesn’t mean to say that all labels are wrong. And just because one person had a bad experience with the wrong label, the supermarket shouldn’t stop using them … otherwise how else is anyone supposed to manage their cans effectively without labels? Honestly, stop looking like a fool by preaching about labels and let the rest of us finish our shopping.”

Dr Caroline Leaf, communication pathologist, self-titled cognitive neuroscientist, and a self-elected champion of irrelevant mental health advocacy, has come out all guns ablazin’ over ADHD labels again. She needs to give it a rest – she’s just like the crazy person standing in front of the supermarket.

“Labels for ADHD are bad”, she says. “Look at Avery Jackson, who was labeled ADHD but did not accept the label. He went on to earn multiple degrees and become one of the top neurosurgeons in the U.S!”  The underlying message – labelling a child with ADHD will lock then into a life of pathetic excuses and they won’t ever reach their full potential until they renounce the curse of their ADHD label.

For every scary anecdote about the evils of ADHD and the mental prison that everyone with such a label is supposed to find themselves in, there are ten more where the ADHD label helped them.  There are so many more people where the ADHD label helped them to finally understand their condition and receive the correct treatment, enabling them to reach their potential and improve their life in leaps and bounds.

Take, for example, one of my patients called Little Jimmy (not his real name). When Little Jimmy was in the early primary school grades, he was a bit of a fidgeter and couldn’t concentrate well enough at school or at home to complete his homework tasks. His mother took him to a naturopath who told him he had a disorder of “pyrolles disease”. Thankfully, mum brought him to see me, and after a careful history and a long chat, Little Jimmy went to see a specialist who diagnosed him with ADHD and commenced him on stimulant medications. Before his label, Little Jimmy’s reading levels were languishing at the bottom off his class after two years of stagnation.  He was more than a year behind in reading levels and going nowhere fast.  Two weeks after getting his label and the right medication, he went to the top three reading levels in the class.  His mother told me of the massive gains he made, and the flow-on effect this had to his self-esteem and confidence in other areas of his school work and school life. She cried as she recounted his story, and then I cried too.

So perhaps Avery Jackson became an orthopaedic surgeon because he chose to ignore his label of ADHD and worked hard anyway.  Good for him.  Little Jimmy got a label of ADHD and because of it, he learnt to read. Now he’s got the chance to follow in Avery Jackson’s footsteps, BECAUSE of his label.

Labels are important. Without them, we wouldn’t know how to know who needs which treatment. Labels can help people overcome some of the strongest barriers and connect with others for support.

And let’s face it, if someone really wanted to, they don’t need a label of ADHD to find excuses in life.

So labels are not a hinderance, but rather, they are a guide to help you know what’s going on so informed choices can be made. In Dr Leaf’s mind, those kids with ADHD are just naughty children, with bad parents, who are using the label of ADHD to cover their poor parenting and their bad behaviour. Clearly all they need to do is to stop their toxic thinking and they wouldn’t need their medications, but they would be cured.

Dr Leaf is wrong … she can stand and scream blue murder about labels and ADHD all she wants.  But just like the crazy random person screaming about labels in front of the supermarket, it means very little. It’s not helping her cause, and if anything, it’s sewing distrust in an system that, despite it’s flaws, works very well, and has helped thousands of children and adults alike to achieve their potential.

That’s the power of labels, and Dr Leaf would do herself and all her followers a favour if she stopped mislabelling them.

Where are all the shepherds?

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In “The Myth of Icarus”, Icarus, full of the folly that comes with pride, flew too high and the sun melted his wings.

Dr Caroline Leaf is the modern day Christian version of Icarus, foolishly flying higher and higher, deluded by her self-importance and unaware of the weakness and fissuring of her presumed competence.

But unlike the myth of Icarus where only Icarus himself paid the ultimate price, Dr Leaf isn’t the only person flying too close to the sun, but she is encouraging the church to follow her lead.

Dr Caroline Leaf is a communication pathologist and self-titled cognitive neuroscientist.  Unfortunately, despite no training or experience whatsoever in psychiatry, psychology or even basic counselling, Dr Leaf has assumed the role of a mental health expert for the church.

Having the untrained Dr Leaf lecture Christian congregations on mental illness is an absolutely absurd proposition – it’s like having a plumber give a public lecture about coronary bypass surgery.  Yet the uncredentialed Dr Leaf continues to speak at church after church after church about mental health and illness, given a free license as if she were a psychiatrist with decades of experience.

And my question is “Why”?

Why do pastors and church leaders give Dr Leaf a free pass to speak from their platforms on a subject that she is objectively unqualified to speak on?  Where is the public process of due diligence? Where is public demonstration of accountability that undergirds the reverence, the sacred gravitas, of the church pulpit? Why do our church leaders stay silent when unqualified preachers poison their congregations with saccharine subterfuge?

Where are all the shepherds?   Why aren’t they shepherding?

Dr Leaf’s latest e-mail newsletter aptly demonstrates what the church needs protecting from – an entire e-mail encouraging people to withdraw from psychiatric medications.  Her bias is clear – psychiatric medications are harmful and you can withdraw from them if you want to.  If you do, you’ll feel better.

This might as well be unsolicited, unlicensed medical advice.  There’s no discussion about the nuances of psychotropic medication, or the proven benefits.  She then encourages people to look for more information by reading books or visiting websites that are known to be unhinged or, at best, clearly biased against medications for mental ill-health.

In the past, Dr Leaf has clearly shown her ignorance when it comes to psychiatric medications.  She has accused them of everything from being poisonous to being unspiritual.  Never once has she acknowledged the scores of research papers that confirm the judicious use of psychiatric medications saves lives and extends the lifespan of those who take them.

Now, she has advised people that they can stop their medications and promotes unscrupulous and biased sources of information to help.  This isn’t just ignorant, this is dangerous. [1]

Will it take the untimely death of one of their congregation before our church leaders say ‘enough is enough’?  It will be all too late then.

It’s time for our church leaders to stand up for the congregations they lead and denounce the teaching of Dr Caroline Leaf.  Her ignorance and her arrogance are becoming a dangerous mix.  Our pastors can’t wait until blood is on their hands before they’re forced into action – they need to act now, before it’s too late.

~ ~
If you are concerned about the medications you’re taking or you think you don’t need them any more, for heaven’s sake don’t just stop taking them or try and wean yourself.  Go see your doctor for advice specific to your medication and your situation.

Don’t believe me? https://psychcentral.com/lib/discontinuing-psychiatric-medications-what-you-need-to-know

DISCLAIMER: Just in case anyone was wondering about my motives, I declare that I have no connection with any pharmaceutical company. I do not accept gratuities of any form from any sales representative. I don’t eat their food, I don’t take their pens, and I don’t listen to their sales pitches.

References and bibliography

[1] Valuck RJ, Orton HD, Libby AM. Antidepressant discontinuation and risk of suicide attempt: a retrospective, nested case-control study. J Clin Psychiatry 2009 Aug;70(8):1069-77.

Anti-depressants – Not the messiah

Dr Caroline Leaf – Howling at the moon

Anti-psychotics, damn lies and statistics

Caroline Leaf – Carrie Fisher killed by bipolar meds

Dr Caroline Leaf – Not a mental health expert

Dr Caroline Leaf – Increasing the stigma of mental illness again


https://cedwardpitt.com/2015/10/18/dr-caroline-leaf-and-her-can-of-worms/
https://cedwardpitt.com/2015/10/19/dr-caroline-leaf-and-the-can-of-worms-update/
https://cedwardpitt.com/2015/10/26/dr-caroline-leaf-and-the-myth-of-chemical-imbalances-myth/

Dr Caroline Leaf – Howling at the moon

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The night is darkest just before the dawn, so says the age-old phrase.  It’s funny how we just accept these old adages as true, but when you actually think about it, they’re nothing more than a concoction of the imagination.  The night isn’t darker just before dawn – it’s just as dark when the sun goes down as it is before the sun comes up again.

In the same way, we so often accept things said by ‘experts’ as truth when in reality, they’re also just some particularly imaginative concoctions.

Take, for example, Dr Leaf’s latest e-mail newsletter and blog for June 2017.  In it, she merrily gloated about how a recent UN Human Rights report “exposed the current failings of diseased-based psychiatry” and “challenges the dominant narrative of brain disease and its overreliance on psychoactive drugs”.  The smugness is palpable – she finally has something more authoritative to try and back up her psychiatric antagonism than just the collective ranting of an outspoken, ill-informed fringe group.

Dr Leaf is a communication pathologist (essentially an academic speech pathologist) though she continues to delusionally claim that she’s a cognitive neuroscientist.  She also grandiosely believes her training in speech pathology make her a mental health expert, above psychiatrists with actual medical training and decades of real clinical experience.  She might feel vindicated by this report and her ill-formed friends, but her view is naive and her narrative is based on inaccurate statistics and logical fallacy.

For example, this paragraph encapsulates Dr Leaf’s statistical errancy and general self-deception: “Several of my previous blogs, as well as some of my FAQs, deal with the current state of mental health care, which has crippled so many lives, led to countless deaths, and left millions of people thinking that there is ‘something wrong with my brain.’ Indeed, an estimated 20% of the American population take psychiatric drugs, which amounts to a staggering cost of $40 billion, as mental health advocate Robert Whitaker points out (a 50-fold increase since the late 1980s).”

It’s a “see-I-told-you-so” attempted justification, except that modern mental health care has not “crippled so many lives” or “led to countless deaths.”  It’s actually untreated mental illness which really cripples people’s lives, or ends them.  Suicide is an unspoken epidemic that is so often the end result of undiagnosed or untreated mental illness.  Suicide is the major cause of premature death among people with a mental illness and it’s estimated that up to one in ten people affected by mental illness die by suicide.  Up to 87% of people who die by suicide suffer from mental illnesses. There are more deaths by suicide than deaths caused by skin cancer and car accidents.  Up to three percent of adults have attempted suicide within their lifetime and it’s estimated that for every completed suicide, at least six other people are directly impacted in a significant way [1].

On the flip side, the use of any anti-psychotic medication for a patient with schizophrenia decreased their mortality by nearly 20% [2]. In another study, the mortality of those with schizophrenia who did not take anti-psychotics was nearly ten times that of the healthy population, but taking anti-psychotic medication reduced that by a factor of five! [3]  Dr Correll and colleagues summarised the literature, noting that, “clozapine, antidepressants, and lithium, as well as antiepileptics, are associated with reduced mortality from suicide. Thus, the potential risks of antipsychotics, antidepressants and mood stabilizers need to be weighed against the risk of the psychiatric disorders for which they are used and the lasting potential benefits that these medications can produce.” [4]

As for her example taken from the equally prejudiced Robert Whitaker that “an estimated 20% of the American population take psychiatric drugs, which amounts to a staggering cost of $40 billion … (a 50-fold increase since the late 1980s)”, even if it were true, it’s simply misleading and ill-informed.  Twenty percent of the US population might be taking “psychiatric drugs” but some of them might be taking them for different reasons.  For example, tricyclic anti-depressants are no longer used primarily for depression but have found a niche in the treatment of chronic and nerve-related pain.  And so what if there’s been a 50-fold increase in the use of psychiatric medications since the 1980’s, that doesn’t mean they’re being used inappropriately.  Her analogy is like saying that because there has been a 900-fold increase in the number of road deaths since the turn of the century [5], cars are being used inappropriately and we should all start travelling by horse-back again.

It’s the height of arrogance for Dr Leaf to sit in her ivory tower and condemn modern psychiatry based on her utopian fantasy, but mental illness affects real people and causes real suffering – like the two heart-broken parents told a Parliamentary Enquiry in Australia a few years back, “We would rather have our daughter alive with some of her rights set aside than dead with her rights (uselessly) preserved intact.” [6]

Dr Leaf may smugly think the sun is shining on her, but she’s still in the darkness of night, barking and howling at the moon like a rabid dog.  If she really wants to step into the light, she should try looking at the mountain of scientific evidence supporting modern psychiatry and if that’s not enough for her, then she should at least look at all those afflicted and distressed because the mental illness they or their loved one suffered from was ignored in favour of an ideology that claims to support human rights but which ignores the most basic human right of all, the right to life.

References
[1]        Corso PS, Mercy JA, Simon TR, Finkelstein EA, Miller TR. Medical costs and productivity losses due to interpersonal and self-directed violence in the United States. Am J Prev Med 2007 Jun;32(6):474-82.
[2]        Tiihonen J, Lonnqvist J, Wahlbeck K, et al. 11-year follow-up of mortality in patients with schizophrenia: a population-based cohort study (FIN11 study). Lancet 2009 Aug 22;374(9690):620-7.
[3]        Torniainen M, Mittendorfer-Rutz E, Tanskanen A, et al. Antipsychotic treatment and mortality in schizophrenia. Schizophrenia bulletin 2015 May;41(3):656-63.
[4]        Correll CU, Detraux J, De Lepeleire J, De Hert M. Effects of antipsychotics, antidepressants and mood stabilizers on risk for physical diseases in people with schizophrenia, depression and bipolar disorder. World psychiatry : official journal of the World Psychiatric Association 2015 Jun;14(2):119-36.
[5]        “List of motor vehicle deaths in US by year” https://en.wikipedia.org/wiki/List_of_motor_vehicle_deaths_in_U.S._by_year Accessed 18 June 2017
[6]        “A national approach to mental health – from crisis to community – First report” 2006 Commonwealth of Australia http://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Former_Committees/mentalhealth/report/c03 Accessed 18 June 2017

Kintsukuroi Christians

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When I was a kid growing up, there wasn’t much that my father couldn’t repair.

Dad was extremely gifted with his hands, a talent that I certainly didn’t inherit. He was able to take a problem, come up with a practical solution in his mind’s eye, then build it out of whatever scraps of wood, metal or plastic he could lay his hands on. It was the ultimate expression of frugality and recycling that comes from a limited income and four growing children.

Dad was also able to resurrect nearly everything that broke in our house. Plates, cups, teapots, toys, tools … it seemed there wasn’t anything that couldn’t be fixed by the careful application of Araldite.

Araldite, for those unfamiliar with it, is some sort of epoxy resin that, in the right hands, possesses mystical properties of adhesion. It would stick anything to anything.

Dad’s gift for repairing things with Araldite meant that a lot of our things were patched up. Some of our most loved possessions were the most cracked. Despite being glued together several times, each item was still functional. Maybe not as pretty as it may have once been, but still useful, and more importantly, still treasured. Each time the Araldite came out, it taught me that whilst all things have the capacity to be broken, they also have the capacity for redemption.

There’s an ancient Japanese tradition that shares the same principles. For more than 400 years, the Japanese people have practiced kintsukuroi. Kintsukuroi (pronounced ‘kint soo koo ree’) is the art of repairing broken pottery with gold or silver lacquer, and the deep understanding that the piece is more beautiful for having been broken.

The edges of the broken fragments are coated with the glue made from Japanese lacquer resin and are bonded back into place. The joints are rubbed with an adhesive until the surface is perfectly smooth again. After drying, more lacquer is applied. This process is repeated many times, and gold dust is also applied. In kintsukuroi, the gold lacquer accentuates the fracture lines, and the breakage is honoured as part of that piece’s history.
Mental illness is a mystery to most people, shrouded by mythology, stigma, gossip or Hollywood hype. It’s all around us, affecting a quarter of the population every year, but so often those with mental illness hide in plain sight. Mental illness doesn’t give you a limp, a lump, or a lag. It affects feelings and thoughts, our most latent personal inner world, the iceberg underneath the waters.

On the front line of medicine, I see people with mental health problems every day, but mental health problems don’t limit themselves to the doctor’s office. They’re spread throughout our everyday lives. If one in four people have a mental health problem of one form or another, then one in four Christians have a mental health problem of one form or another. If your church experience is anything like mine, you would shake hands with at least ten people from the front door to your seat. Statistically speaking, two or three of them will have a mental illness. Could you tell?

It’s a fair bet that most people wouldn’t know if someone in their church had a mental illness. Christians battling with mental illness learn to present a happy façade, or face the judgment if they don’t), so they either hide their inner pain, or just avoid church altogether.
Experiencing a mental illness also makes people feel permanently broken. They feel like they’re never going to be whole again, or good enough, or useful, or loved. They’re often treated that way by well-meaning but ill-informed church members whose idea’s and opinions on mental illness is out-of-date.

The truth is that Christians who have experienced mental ill-health are like a kintsukuroi pot.

Mental illness may break them, sure. But they don’t stay broken. The dark and difficult times, and their recovery from their illness is simply God putting lacquer on their broken pieces, putting them back together, and rubbing gold dust into their cracks.
We are all kintsukuroi Christians – we’re more beautiful and more honoured than we were before, because of our brokenness, and our recovery.

I’m pleased to announce that my book, Kintsukuroi Christians, is now available. I’ve written this book to try and bring together the best of the medical and spiritual.
Unfortunately, good scientific information often bypasses the church. The church is typically misled by Christian ‘experts’ that preach a view of mental health based on a skewed or outdated understanding of mental illness and cognitive neuroscience. I want to present a guide to mental illness and recovery that’s easy for Christians to digest, adopting the best spiritual AND scientific perspective.

In the book, I look at some scientific basics. Our mental world is based on the physical world. Our mind is a function of the brain, just like breathing is a function of our lungs. Just as we can’t properly understand our breathing without understanding our lungs, so it is that if we’re going to understand our thinking and our minds, we are going to have to understand the way our brain works. So the first part of this book will be an unpacking of the neurobiology of thought.

We’ll also look at what promotes good mental health. Then we’ll look at what causes mental illness, specifically looking at the most common mental health disorders. I will only look at some of the most common disorders to demonstrate some general principles of psychiatric illnesses and treatments. This book won’t be an encyclopaedia, and it doesn’t need to be. I hope to provide a framework so that common and uncommon mental health disorders can be better understood. I also discuss suicide, which is sadly more common than most people realise, and is rarely discussed.

I know mental illness is difficult, and we often look at ourselves or others as though the brokenness is abhorrent, ugly and deforming.
My hope is that through Kintsukuroi Christians, you’ll see the broken pieces are mended with gold, and realise that having or recovering from a mental illness doesn’t render someone useless or broken, but that God turns our mental brokenness into beauty.

Kintsukuroi Christians is available to purchase from good Christian bookstores around the world including:

Kooyong = https://www.koorong.com/search/product/kintsukuroi-christians-christopher-pitt/9780994596895.jhtml

Amazon US = https://www.amazon.com/Kintsukuroi-Christians-TURNING-MENTAL-BROKENNESS/dp/0994596898/

Amazon UK = https://www.amazon.co.uk/Kintsukuroi-Christians-TURNING-MENTAL-BROKENNESS/dp/0994596898/

Smashwords = https://www.smashwords.com/books/view/720425

~~

Mental illness can be challenging. Sometimes learning about mental illness can bring up difficult feelings or emotions, either things that you’ve been through yourself, or because you develop a better understanding of what a loved one is going through or has been through. Sometimes old issues that have been suppressed or not properly dealt with can bubble up to the surface. If at any point you feel distressed, I strongly encourage you to talk to your local doctor, psychologist, or pastor. If the feelings are so overwhelming that you need to talk to someone quickly, then please don’t delay, but reach out to a crisis service in your country

In Australia
Lifeline 13 11 14, or
BeyondBlue
Call 1300 22 4636
Daily web chat (between 3pm–12am) and email (with a response provided within 24 hours)  https://www.beyondblue.org.au/about-us/contact-us.

USA = National Suicide Prevention Lifeline 1-800-273-TALK (8255)

New Zealand = Lifeline Aotearoa 24/7 Helpline 0800 543 354

UK = Samaritans (24 hour help line) 116 123

For other countries, Your Life Counts maintains a list of crisis services across a number of countries: http://www.yourlifecounts.org/need-help/crisis-lines.

Hollywood knows more about cognitive neuroscience than Dr Caroline Leaf

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Anyone ever watched the Will Smith movie, “Concussion”?

The movie is based on the true story of Dr Bennet Omalu who is a Nigerian-born pathologist (a pathologist is a forensic specialist who is able to determine the cause of a person’s disease and death).  Dr Omalu became curious as to why otherwise healthy middle-aged men were displaying changes to their behaviour and memory before dying at a young age.

What he found was changes to the brain of these NFL players similar to that seen in Alzheimer’s Disease.  The recurrent physical head trauma sustained by those football players was resulting in abnormal proteins in their brain cells.  The abnormal proteins resulted in the destruction of those brain cells.  As a result of the destruction of those brain cells, the thinking and behaviour of those players changed.

After initially denying the link, the NFL was forced to change their policy on repetitive head trauma under the weight of the avalanche of confirmatory data that followed in support of Dr Omalu’s findings and it’s been reported that “as of the summer of 2015, more than 5,000 former players were involved in a consolidated lawsuit, with a settlement figure of $765 million deemed insufficient by a judge”.

But good news for the NFL … self-titled cognitive neuroscientist Dr Caroline Leaf reassures us that “Your mind controls your brain.  Your brain does not control your mind.”

Maybe she can act for the NFL as their star witness.

But if I were her, I wouldn’t be holding my breath.  After all, it’s not like she’s able to mount particularly strong logical arguments.  Today she wrote on Facebook, “It’s important to remember that our thinking changes the structure of our brains because our minds are separate from our brains.”

How is the mind going to control the brain if they’re separate?  Suggesting that one thing controls another carries the implication that they are intrinsically linked.  If your hands are separated from the steering wheel of your car, are you in control of your car?

The other reason why Dr Leaf won’t be getting a call from Roger Goodell any time soon is because she isn’t really an expert on cognitive neuroscience as much as she’s convinced the Christian church otherwise.

Oh, and then there’s that minor detail that even Hollywood knows more about cognitive neuroscience than she does.  The whole point of “Concussion” is that brain damage results in disordered thinking which is the exact opposite of what Dr Leaf is trying to claim, and it’s hard to withstand any real scrutiny when your hypothesis has been trumped by a Hollywood screenplay.

The mind is a function of the brain, it does not control the brain.  The fact that Dr Leaf can not or will not bow to the weight of the undeniable scientific evidence means that she is either delusional, ignorant or utterly obstinate.  The fact that the western church is still willing to deify Dr Leaf in spite of these qualities is a stain on the reputation of the church and a blight on it’s witness to a world which only needs to look to Hollywood to find more credible information than what’s coming from Dr Leaf’s pulpit.

Dr Caroline Leaf and Testimonials – Good marketing, poor evidence

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Dr Caroline Leaf is a communication pathologist and self-titled cognitive neuroscientist. She is a pseudoscientist of the highest order. She once wrote a PhD. Now she has episodes of her TV show titled “Surviving cancer by using the Mind”.

This weeks edition of her newsletter started off with some subtle boasting:

“We have received many E-mails over the past years asking for Testimonies with regards to Dr Leaf’s research and teachings. We have summarized eight pages of testimonies received at TESTIMONIES. Be encouraged and feel free to refer them to friends, family, acquaintances, and work colleagues struggling with Mind issues.”

Testimonials are an empty box wrapped in shiny paper and trimmed with a bow. They look really good but offer nothing of substance. They’re simply an old advertising trick.

According to the Market Science Institute, “Testimonial solicitations – in which firms solicit consumers’ personal endorsements of a product or service – represent a popular marketing practice. Testimonials are thought to offer several benefits to firms, among them that participating consumers may strengthen their positive attitudes toward a brand, through the act of writing testimonials.” [1]

Who can argue with a person who says that Dr Leaf helped turn their life around? Saying anything negative just makes you sound like a cynical old boot.

And that’s the real problem, because while publishing a whole bunch of positive stories is good for marketing, it makes it very hard for those who had a genuinely bad experience to say anything. No one wants to listen to those people whom Dr Leaf has confused or mislead – it makes for terrible PR. Those people feel devalued, and sometimes worse, because it seems like everyone else had a good result from Dr Leaf’s teaching, except them.

Testimonials also make for very poor scientific evidence. Indeed, testimonials are considered the lowest form of scientific evidence [2]. It’s all very well and good for a bunch of people to share their positive experiences, but as life changing as the experience may have been, they are not evidence of the effectiveness of Dr Leaf’s teaching. Without specific, well-designed research, no one can say if the testimonials Dr Leaf is publishing are the norm. Recent research demonstrates that self-help literature for depression may not have any benefit over a placebo treatment [3]. So it may be that any improvement attributed to Dr Leaf’s teaching was actually the placebo effect. Dr Leaf can list testimonials until she’s blue in the face, but that doesn’t prove that her work is scientific or therapeutic.

Indeed, selectively publishing testimonials is duplicitous, telling half-truths, positively spinning her own story. How many e-mails has Dr Leaf gotten from people who have found her teaching inaccurate, ineffective, unbiblical or harmful? Dr Leaf’s social media minions deliberately delete any negative comments and block anyone from her sites that disagree with her. And over the years, many people have shared with me how arrogant and dismissive her team has been to polite, genuine concern or criticism. I can personally attest to the same treatment. If Dr Leaf was honest with her followers, she would be openly publishing the brickbats as well as the bouquets.

For her readers and followers, the testimonials need to be seen for what they are: just individual stories. Sure, we should rejoice with those who are rejoicing (Romans 12:15), and so good for those who feel Dr Leaf has helped them. But they do not constitute evidence for the therapeutic efficacy or scientific integrity of the work of Dr Leaf.

For people genuinely struggling with “mind issues”, the last thing they need is testimonials collated by Dr Leaf’s marketing team.  They don’t need to be referred to Dr Leaf’s work, they need to be referred to psychologists and doctors.

And if Dr Leaf really wanted to prove her legitimacy, she would rely on independent peer-reviewed published research, not on the list of vacuous, self-serving cherry-picked testimonials that she is currently offering.

References

[1] Marketing Science Institute. Consumer Testimonials as Self-Generated Advertisements: Evaluative Reconstruction Following Product Usage. [cited 2014, Aug 3]; Available from: http://www.msi.org/reports/consumer-testimonials-as-self-generated-advertisements-evaluative-reconstru/.
[2] Fowler, G., Evidence-based practice: Tools and techniques. Systems, settings, people: Workforce development challenges for the alcohol and other drugs field, 2001: 93-107
[3] Moldovan, R., et al., Cognitive bibliotherapy for mild depressive symptomatology: randomized clinical trial of efficacy and mechanisms of change. Clinical psychology & psychotherapy, 2013. 20(6): 482-93

Dr Caroline Leaf – Not a mental health expert

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Dr Caroline Leaf is a communication pathologist and self-titled cognitive neuroscientist.  She wrote a PhD on a learning program developed for an educational setting.  She is not a medical doctor.  She is not a psychologist.  She has no experience or training in the diagnosis and management of mental illness.  She is no more qualified to give advice on mental illness than my hairdresser is.

And it shows in her latest social media post: “Lets really start loving as a church- true unconditional non judgmental love – pushing people away and locking them up and drugging them against their will is not the solution to the the problems of life.”

Her statements is a nonsense, nothing more than a scarecrow fallacy.  Yes, pushing people away and locking them up and drugging them against their will is not the solution to the problems of life, that’s why no one does it.  If people were locked up or drugged against their will because of “the problems of life” then we’d all be locked up and drugged.

The only people that are forcibly treated are those with the most serious of mental illnesses whose condition has deprived them of the insight they need to make the decision for themselves.  Even then, the consent for treatment is given by the next of kin, and if no next of kin can provide consent, then the consent is usually made by a independent statutory body so there’s no conflict of interest.

That Dr Leaf continues to make such inane statements about mental illness confirms that she is not fit to give the church, or anyone else for that matter, any advice on mental health.  She may have a PhD in communication pathology but that is a highly specialised field that doesn’t even begin to cross over to clinical knowledge of mental illness.

Dr Leaf has chosen to fill her vacuum of mental health experience with the opinions of Mad In America, a group that’s irrationally biased against modern mental health care.  She regurgitates their creed almost verbatim – mental illness is over diagnosed, psychiatric medications are useless and dangerous, and Dr Leaf also claims that psychiatric medications are only prescribed to bring the cabal of the American Psychiatric Association and the pharmaceutical companies more power and money.

Psychiatric medications are more helpful than harmful (Leucht et al, 2012, Torniainen et al, 2015).  I’ve discussed this in blog posts in the past.  Yes, they’re not without their side effects, and they’re not for every patient, but they have their place in psychiatric care.  That Dr Leaf can’t or won’t review this evidence is just another indictment against her ministry.  That she actively promotes the idea that pharmaceutical companies and the APA are actively attempting to harm people for their own power and riches is scandalous.

If Dr Leaf was serious about promoting good mental health through the church, she should stop promoting baseless anti-psychiatric propaganda, and start encouraging Christians with mental illness to seek the best treatment available, whether that be medications or counselling or both.  She should also start teaching the church the truth about mental illness … That mental illness isn’t caused by poor choices or toxic thoughts, but because of genetic abnormalities that make the affected persons brain more vulnerable to external stress.

Because to stop turning pain and trauma into shame, anger, fear and then hate, people need correct information to allow them to offer real loving understanding and nonjudgmental support to move through the pain.  At the moment, Dr Leaf isn’t offering the church anything even close to that.

References

Leucht S, Tardy M, Komossa K, et al. Antipsychotic drugs versus placebo for relapse prevention in schizophrenia: a systematic review and meta-analysis. Lancet 2012 Jun 2;379(9831):2063-71.
Torniainen M, Mittendorfer-Rutz E, Tanskanen A, et al. Antipsychotic treatment and mortality in schizophrenia. Schizophrenia bulletin 2015 May;41(3):656-63.

Dr Caroline Leaf – Increasing the stigma of mental illness again

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Let me tell you a story.

A couple of years ago, one of my patients was an elderly gentleman in his late seventies.  He was living in a nursing home at the time, but because of his history of psychosis, he remained on a treatment order – a requirement by law that if he was to remain outside of a mental facility, he had to have regular anti-psychotic medication every few weeks.

This man was on a treatment order because his disease caused him to have delusions.  He misinterpreted what was going on around him, and would not consider that he could be wrong.  In his particular case, he was convinced that his next-door neighbour was a paedophile, and he was planning to ambush his neighbour and castrate him.  Luckily the police had taken my patient into custody before he got the opportunity.  With treatment, my patient had clear thoughts, although needed close supervision.  Without his medication, he became confused and violent.

According to a post on the blog Mad in America and promoted by Dr Caroline Leaf, my patient’s diagnosis was spurious, and he was denied his basic human rights by being forced to take medications.

Dr Caroline Leaf is a communication pathologist and self-titled cognitive neuroscientist.  She is also a self-declared expert in mental health, despite not having any professional training in medicine, psychiatry, psychology or even cognitive neuroscience for that matter.

Indeed, if she had any experience or expertise in mental health, she would have recognised the basic factual errors and logical fallacies that riddled the post she quoted from.

Take the quote that Dr Leaf posted on social media.  The full quote from the Mad in America post is:

“Despite the fact that no one in history, not even the omnipotent American Psychiatric Association – which produces and profits mightily from the ‘Bible’ of mental disorders — has come up with a halfway good definition of “mental illness,” and despite the fact that the process of creating and applying the labels of mental illness is unscientific, any of those labels can be used to deprive the person so labeled of their human rights. This is terrifying. It ought to terrify those who are so labeled and those who are not, because deprivation of human rights on totally arbitrary grounds is inhumane and immoral.”

This is the same tired, emotionally laden and misleading rhetoric that’s so often barked in fervent paroxysms through the foaming lips of those opposed to modern psychiatric practice:

  1. There is no good definition of ‘mental illness’
  2. The American Psychiatric Association is just a profit-driven cabal
  3. The DSM5 (which the author alludes to as the ‘Bible’ of mental disorders) is unscientific
  4. Psychiatric diagnoses are unscientific
  5. Any psychiatric diagnosis can be used as a trigger to force people into unwanted treatments or incarceration
  6. Therefore psychiatric diagnosis and treatment is against basic humans rights and is inhumane and immoral.

Inhumane and immoral hey?  Tell that to my patients neighbour who almost became a eunuch except for that “inhumane and immoral treatment” of my former patient.

Caplan claims just don’t stand up to any rational scrutiny.

  1. There are lots of good definitions of mental illness … modern psychiatry critics just don’t like them. But take the definition used by the CDC, “Mental illness is defined as … ‘health conditions that are characterized by alterations in thinking, mood, or behavior (or some combination thereof) associated with distress and/or impaired functioning.’” There’s nothing wrong with this definition. It describes mental illness and helps differentiate mental illness from variations of mood, thought and behaviour that are part of the everyday human experience.
  1. The American Psychiatric Association isn’t the only group to have created a classification of psychiatric illnesses. The World Health Organisation publishes the International Classification of Diseases, or the ICD, which is also used for psychiatric diagnosis. Is the WHO an evil profit-driven junta too?
  1. The DSM, the ICD, and any other system of diagnosis, are simply different classification systems. Over the last century, clinicians have noted clusters of symptoms and have tried to classify them into common groups. How is that unscientific?  It’s no different to scientists looking at the different characteristics of various animals and creating a taxonomy, to provide a common system and language for clinicians and researchers across disciplines and across countries.The DSM system isn’t perfect, but what system ever is?  As knowledge of neuroscience grows, the classifications are reviewed and tightened in an ongoing process of improvement.  If those who oppose the DSM want to come up with something better, they’re welcome to put something forward.
  1. The old saying goes that medicine is an art and a science. Human beings, as nuanced as we are, often don’t fit into diagnostic criteria as easily as we would like. That doesn’t invalidate the diagnostic criteria or make the process unscientific as critics of modern psychiatry would have us believe, just like an unusual and hard-to-classify form of cancer doesn’t invalidate the other cancer classifications that are well defined.  Psychiatry, by it’s nature, relies on verbal report from patients rather than a clean-cut blood test or piece of tissue under a microscope, so at this stage in history, it seems imprecise.  That doesn’t make it any less scientific.
  1. The allegation that any psychiatric diagnosis can any be used to deprive the person so labeled of their human rights is utter nonsense. It’s a giant scarecrow – it seems really scary, but on closer inspection, it’s just a tarted-up mound of straw.People are never forced into treatments unless they really are “dangerous to themselves and/or others”.  This rule can’t be invoked willy-nilly.  There are multiple checks and balances, and a whole school of civil rights lawyers expectantly circling, ready for the whiff of blood in the water (http://www.mhrt.qld.gov.au/?page_id=2 is an example of the process in my home state, but each jurisdiction has their own version).

Caplan rightly pointed out that those with mental illness were less likely to be the perpetrators of violence and more likely to be the victims, but that doesn’t negate the need for protection of the community from those with mental illness who have shown violent intent and no capacity to control their behaviour.

If you want to find a group that really are suffering from inhumane and immoral deprivations of their human rights, then that would be Christians.  Around the globe, millions of Christians are oppressed, imprisoned, tortured, raped, and murdered every year.

Time and space preclude a full analysis of Caplan’s post, but what’s really important is that both the American Psychiatric Association and the U.S. Department of Health and Human Services’s Office of Civil Rights, an independent ombudsman, dismissed formal appeals by Caplan relating to her hysterical claims of inhumane forced psychiatric treatment.  Dr Leaf conveniently left that out of her social media post.

Instead, Dr Leaf chose to publish one of the most alarming quotes from an article heavy on scaremongering, from a disaffected author on an extremist blog.  If Dr Leaf was a real expert on mental health instead of being a self-declared one, she would have easily seen how nonsensical Caplan’s post was.

By posting this quote on social media today, it’s highly likely that Dr Leaf has caused harm to thousands of vulnerable Christians by unnecessarily increasing the stigma and fear of a mental health diagnosis.  This, in turn, is likely to lead to these same vulnerable Christians missing out on (drug and non-drug) treatment which would help them rise to their true potential in God and in life, leaving them trapped and suffering in their mental destitution.

Dr Leaf has a track record of misinformation when it comes to mental health.  Christians suffering mental illness need more support, not more stigma.  It’s time Dr Leaf stepped aside, and stopped making things worse.